New York hospitals fall in latest U.S. News rankings

Montefiore to study cannabis for chronic pain

The National Institutes of Health has awarded researchers at Albert Einstein College of Medicine and Montefiore Health System $3.8 million to conduct the first long-term study examining whether patients who use medical marijuana to treat chronic pain can reduce their opioid use, the health system is announcing Tuesday.

Previous studies have found correlations between medical marijuana legalization in a state and lower rates of opioid prescriptions and overdose deaths. Doctors who prescribe medical marijuana have also reported anecdotally that patients are able to cut back on opioids or stop using them altogether. However, there has been a shortage of scientific evidence to back up these emerging connections.

"There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain," Dr. Chinazo Cunningham, associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant, said in a statement. "We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance."

At first, Cunningham and her colleagues struggled to gain NIH approval to conduct the study the way they wanted to, Cunningham told Crain's in January. NIH originally suggested the researchers use cannabis from a government source and administer it to patients themselves. In the end, however, Cunningham received approval for patients involved in the study to get medical marijuana through local dispensaries, as they normally would, and report on their progress over 18 months. —C.L.

Brooklyn medical office plans layoffs

A year after 1199 SEIU organized workers at a Brooklyn medical practice, management will lay off 25 workers once it relocates a urology clinic and wound-care center, the union said.

MSO of Kings County, the management-services organization that runs the clinic, said it would begin laying off workers around Oct. 31, according to a filing with the state Department of Labor. The organization provides administrative services for physician practices affiliated with New York-Presbyterian/Brooklyn Methodist.

The organization told the union that the layoffs are related to a planned relocation because the current office is not in good condition, said Antonio Howell, an 1199 vice president.

"If the practice is moving, there's no reason that these workers should not move with the practice," he said.

Joanne Kennedy, human resources business partner at MSO of Kings County, deferred questions to the organization's attorney, who did not return a phone call seeking comment.

Last year, as 1199 sought to unionize office assistants, medical assistants, licensed practical nurses and hyperbaric technicians at the Park Slope practice, MSO of Kings County said it was a distinct entity from the hospital, then known as New York Methodist Hospital. The National Labor Relations Board ultimately ruled that the hospital and MSO were a single employer, allowing the workers to be covered under the union's contract with the hospital. —J.L.

Interfaith plans integrated behavioral health clinic

Brooklyn's Interfaith Medical Center is seeking to relocate mental health and substance-abuse services from its main campus to a nearby clinic in order to create an integrated outpatient center for primary and behavioral health care. The $2.1 million project is in line with the general shift toward integrated care taking place among New York providers, which the state is encouraging through DSRIP and other programs. Relocating the services will help Interfaith cut down on avoidable hospital use and achieve other DSRIP goals, the hospital said in its certificate-of-need application to the state Department of Health.

The project would require the renovation of 16,210 square feet of space at the Bishop O.G. Walker Jr. Health Care Center on Prospect Avenue. Interfaith plans to transform the third floor into its behavioral-health hub and move the existing services there to the first floor.

The state has already awarded Interfaith funds to complete the project through the Capital Restructuring Financing Program, and the hospital is now requesting final approval for its plans. —C.L.

AT A GLANCE

NALOXONE COPAYS: Starting Wednesday the state will cover insurance copays of up to $40 for people purchasing the opioid-overdose-reversal drug naloxone at pharmacies in New York, Gov. Andrew Cuomo announced Monday. Free naloxone will continue to be offered through state partners, such as harm-reduction organizations.

COST OF LONELINESS: The growing trend of social isolation is a major public health threat contributing to premature deaths, according to an article published in Fortune. The impact of loneliness on mortality exceeds that of many leading health indicators, according to a researcher quoted in the piece.

BELLY UP: The collapse of long-term-care insurer Penn Treaty American Corp., of Allentown, Pa., could push health care premiums higher for everyone, as insurers pony up to help pay for the claims through state guarantee associations, reported Kaiser Health News.

New York-Presbyterian Hospital once again was named the metro area's top hospital in U.S. News & World Report's annual ranking published this morning. However, NYP, Mount Sinai Hospital and NYU Langone Medical Center all fell in national stature compared to last year's list.

New York-Presbyterian fell to No. 8 from No. 6 in the 2017-2018 Best Hospitals Honor Roll, which recognizes facilities nationwide that demonstrate high-quality care across multiple specialties. Mount Sinai dropped to No. 18 from No. 15, and NYU Langone plunged nine spots to 19 from 10.

Mount Sinai Hospital now holds the No. 2 ranking in the metro area, ahead of NYU Langone, for the first time since 2011.

A spokeswoman for NYU Langone said the system believes U.S. News may have erroneously included the performance of the former Lutheran Medical Center from 2013 to 2015 as part of its own quality data, despite the fact that the Sunset Park hospital, now known as NYU Langone – Brooklyn, didn't join the system until 2015.

"NYU Langone became a 'top' hospital by doing what's right for our patients," the spokeswoman said. "The importance of our work far exceeds the weight of any opaque system of rankings."

Other health systems focused on their inclusion in the list rather than the slip in the national rankings.

"Every day our staff demonstrates a remarkable commitment to providing world-class care," said Dr. Steven Corwin, president and chief executive of New York-Presbyterian. "We are proud to be recognized as one of the best hospitals in the country."

New York-Presbyterian noted its status among the top five hospitals in six specialties: cardiology and heart surgery, diabetes and endocrinology, nephrology, neurology/neurosurgery, psychiatry and rheumatology.

Among other specialties, Hospital for Special Surgery was top-ranked nationwide in orthopedics, Memorial Sloan Kettering Cancer Center was ranked second in cancer care, and Mount Sinai was No. 3 in geriatrics.

"The passion of our faculty and staff, along with a commitment to innovation, collaboration, and individualized patient care, has made this recognition possible," said Dr. Kenneth Davis, president and chief executive of Mount Sinai Health System, in a statement.

U.S. News' rankings measure data on outcomes, specifically risk-adjusted mortality and structure, which it defines as nurse staffing levels, accreditations and patient volume. The rankings also take into account reputation as measured by physician surveys.

Mayo Clinic in Rochester, Minn., earned the top spot in the national rankings for the second straight year.

This year the publication began adjusting scores based on patients' socioeconomic status, using the portion of patients who are dually eligible for Medicare and Medicaid as a proxy. The adjustment resulted in a one-week delay in the report's release because U.S. News discovered errors in the data it used to rank facilities across 12 specialties.

Hospitals have criticized the rankings as too narrow, because they cover only Medicare cases, not patients with Medicaid or employer-sponsored insurance, and subjective, given the weight placed on physician surveys, 27.5%.

For some specialties, such as psychiatry and ophthalmology, U.S. News relies solely on doctors' opinions of hospitals as assessed in surveys.

"We believe that the information they use should be based on a standard set of measures that are valid, reliable and evidenced-based," Loretta Willis, vice president of quality and research initiatives at the Healthcare Association of New York State, told Crain's in July. "Surveys are opinion-based and don't follow that thinking." —J.L.

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